I’m 18…Take That Mom!

When working with adults, the rule regarding confidentiality is simple: if there is reason to believe that a client is an imminent danger to himself or someone else, this must be reported to the proper authorities. For minors, the authority in this case is usually the parents as opposed to the police or local hospital. People under 18 are not granted the same confidentiality as adults. Parents have a legal right to know what goes on behind the therapy door. That being said, at the onset of therapy I ask parents to essentially waive that right, because if a child or adolescent cannot speak freely without fear than the therapy is not going to progress very far. I always assure parents that if there is something truly important that they need to know, the information will be given to them:

“What if he says he hates me. Will you tell me that?”

“No.”

“But I just couldn’t bear it if he hated me!”

“I think we can figure out a way for you to bear it. I don’t know if he hates you or not but if he does then maybe therapy will stop him from feeling that way about you.”

“What if he’s doing heroin?”

“I do not allow heroin in my office.”

“No, I mean on the streets with…with soccer hooligans. Will you tell me that?”

“Yes I will tell you that. But please understand that I will tell him all of the rules about confidentiality first because I do not want him to believe that he has been tricked into confessing something.”

“What if he’s sad? Will you tell me that?”

“You know he’s sad, that’s why you brought him here.”

“But what if he’s really, really really sad?”

“Mrs. _______, if your son is in a truly bad spot, something I can’t help him with, or anything that might involve him doing something harmful to himself, believe me both he and I will tell you immediately. Now please leave this office and peruse the fine collection of periodicals in the waiting room that have been ordered for your reading pleasure.”

At one point in my career I was working with an adolescent female who was 17 years and 10 months old. This is an awkward age for therapy because the legal ramifications are still intact for another two months, so if her overly involved parents demanded to know the minutiae of the session I would have been required to give it. An astute teenager (such as this one) would therefore simply wait until her 18th birthday to reveal anything important if she wants to keep her secrets.

Sure enough, at approximately 17 years, 11 months, 23 hours and 59 seconds of this young woman’s life I got the Drunk Dial on my voicemail:

“Dr. Rob! I just turned eighteen about…9 seconds ago and I wanted to say that I’m WASTED! I’ll probably have sex tonight too, you know, to celebrate being eighteen and all. I’m not a minor anymore, I’m…a Major! My mom will ask you details about tonight because she’s so worried about my new boyfriend with all the tattoos. But now you don’t have to tell her anything! Yes! Oh my God! You rule Dr. Rob, and thank you for all of your help. See you next week!”

I then heard a strange noise that sounded like “glecchsh,” which might have been her vomiting onto her cell phone, or possibly just her stepping in some mud.

Sure enough, my newly-crowned Adult client’s mother had questions and needed to be reminded of the rules.

“I want to know what happened at that party.”

“I’m sorry but you are going to have to ask her yourself.”

“What if she did drugs, like … LSP?”

“I believe it’s LSD. Regardless I cannot share that information.”

“But you could have shared it with me three days ago!”

“That’s correct.”

“That’s so stupid. Plus I’m paying for these sessions.”

“I’m sorry Mrs. _______, but payment doesn’t give you any additional rights unless your daughter agrees. You know, lots of parents have difficulties with their child’s transition into adulthood. Maybe I can help you.”

“Help me? You’re condoning the use of LSC!”

“It’s LS…look, if you’d like any further information about your daughter’s treatment please ask her yourself. Now please leave this office and peruse the fine collection of periodicals in the…”

“Oh shut up! You will not see me again at these sessions you…you…withholder!”

Turning eighteen while you are in therapy certainly has its privileges, wouldn’t you say?

This entry was posted on Thursday, February 14th, 2008 at 8:41 am and is filed under Blog. You can follow any responses to this entry through the RSS 2.0 feed.
Both comments and pings are currently closed.

Hey Dr. Rob. I wanted to say that I’m a huge fan, but you’ve got a couple of typos.
Paragraph 2: “wave” should be “waive”
Paragraph 5: “bare” should be “bear.”
Keep up the good work (no sarcasm intended).

I had a psychiatrist when I was 17 who I just couldn’t stand. 17 years and some months and she refused to treat me with any respect whatsoever. One of the first times I saw her, we were scheduling the next appointment, and my mum said to me “Okay, put that date in your phone.” The doc was like “Oh no! It’s mommy’s job to keep track of the appointments. We can’t trust the little one to remind mommy when her appointments are!” No. Joke.

that is just unremarkable that a woman that age would do something i do not live in the states but me and my husband have never done drugs she really should take up religion that’s what kept me from ‘experimenting’ as the young ones say my father has experimenting drugs i have forbidden him to seeing me and my child at the moment since he has been to rehab over 3 times now and have not gone threw his ways and quit it will make the family poor and it will bring bad influence to my child!

but psychiatrist’s don’t help i’ve been to one plenty of time’s they have stolen my papers saying i drew naked people when i wasn’t (i went to school in the states but everything was so different there the psychiatrists would keep on saying i had a mental disorder but they kept on having to check more then twice because they wanted me to have one like my mother so they can keep giving her pills the PILLS MADE HER GAIN WEIGHT she is still the same weight now that she took those pills when those pills were for bipolar apparently! i graduated school back here in europe when i was 15.

people definitely shouldn’t even bother with 18 year olds it’s better off ignoring them there will be a time and point when an 18 year old keeps on trying to get attention you just got to ignore it because obviously they have to figure out in a point in time that they are not the only ones in this world and that a life changing decision like doing drugs will definitely change everything, even how they are in college they would have to go to a frat college where its no work and all play and they just keep holding off their studys, it is despicable and this is why people look at people my age instead of for who i am because everyone just looks at that if people looked at that girls mind instead of her age she really wouldn’t be this way!

i bet her mom said “no your just 17” when she wanted to move out she should have had her move out see how hard it is to get an apartment but then just maybe let her come back its a hard world out there and she has to know that, i also have a thing for men with tattoos but you know what they are just going to grow up gross skin over time unless they use lotion twice a day because that skin just really is disgusting when you look at it.

Sixteen year old mom, you best be trolling or you’re an idiot. As a 20 year old guy with parents that rarely listened I can say that your recommendation to ignore 18 year olds is the worst idea ever. The ones that are doing anything to get attention are the ones that need people to listen to them the most. You want to ignore cutters, those with suicidal thoughts, the addicts and the violent teens? If everyone followed your plan many teens would die due to these problems. Ignoring the issue won’t make it go away, it’ll just make it affect you more when you aren’t ready for the consequences.

Religion is not always the answer either. Yes, I do believe in God, but not the same way as almost all organized religions do. The problem I have with alot of religions is the amount of BS that stems from the people running the church systems. I believe that everyone believes for a different reason and that they have to find their faith in their own way.

Also if you name means what I think it does (that you are 16 and have a child), then in my book you aren’t doing too great yourself. I don’t think it’s very responsible to have a child at that age, regardless of whether you have graduated or not. I would find it hard to believe that you have the financial stability to be able to provide for you child both phisically (good house, food, diapers, etc) while still being able to be present and not at work. If instead you are the mother of a 16 year old, well you better take them to someone because your kind of attitude is what puts kids in that state.

Dr. Rob, I’d tell the parent that their attitude and that kind of prying is exactly what makes the therapy necessary. Parents need to understand that trying to control ever part of their child’s life will result in major resentment towards them. They have to let their children learn about the world on their own. They can’t protect them from everything forever and in trying to do so parents are just crippling their kids’ ability to deal with the world. Keeping your kids locked away from drugs, alcoholic, and sex will just make their first forays into those things that much more extreme. Instead parents should be teaching their kids to be able to make good decisions and be responsible.

Sixteen year old mom: There are 447 words in your comment, and only 4 sentence ending characters (2 periods, 2 exclamation points). No matter what your thoughts are, an important step in sharing them on the internet is proper punctuation.

I find your dialogue and this posting disrespectful. There is an absence of empathy and grace and it teaches the newly minted “adult” that you can treat others with contempt. Surely a good therapist can help with separation in a much better, more dignified, compassionate manner. You seem to forget that the parents are held to an incredibly high standard of responsibility these days. If this kid had gone out and gotten preggers or od’d the howling for the parents’ heads would be loud and strong. The parent tries to guide and protect a kid form their own stupidity and bad choices and the parent is seen as an object of contempt. Article after article tells people that the adolescent brain is not fully formed and that’s why kids do stupid things…so they should not be tried as adults etc. but then you advocate that a parent is just a meddlesome tool to try to deal with the biological facts. YOu should be helping both understand each other’s points of view and showing them how to have respect for each other. At the day’s end, you therapist, do not have pay the price for a reckless, rebellious child – the parents do. So instead of shitting on them and encouraging a child to shit on them, your job needs to be one of support for BOTH. unless, of course, you want to be there in the hospital or changing nap pies while the drug dealer with the tattoos holds a gun to your daughter’s face and forces her to sell drugs. Nah, didn’t think so. So do your part or be wiling to walk the talk of fostering dis respect and contempt for one’s parents.